title: Infective endocarditis in an Indian setup: Are we entering the 'modern' era?
abstract: BACKGROUND
  The clinical profile of infective endocarditis (IE) has been continuously evolving over last 3-4 decades as highlighted by many studies from developed world.
  
  
  OBJECTIVE
  To evaluate the recent changes in the spectrum and clinical profile, and outcome of IE in an Indian setup.
  
  
  METHODS
  This was a descriptive, cross-sectional study. Demographic, clinical, characteristics, treatment, and outcome were examined in 'definite' cases of IE admitted at our institute between July 2005 and December 2010.
  
  
  RESULTS
  61 'definite' cases were identified. Mean patient age was 49.3 ± 13.7 years. Male to female ratio was 3.3:1. Rheumatic heart disease was the underlying heart disease in 23 (37.7%) patients. 33 (54.1%) patients had already received antibiotic therapy before presentation to us. Blood cultures were positive in 41 (67.2%) patients. Streptococci and staphylococci were the commonest microbial isolates, 9 (21.4%) patients each. Transesophageal echocardiography (TEE) was done for all the patients. Vegetations were detected in 54 (88%) patients. Surgery was done in 30 (49.2%) patients. In-hospital mortality happened in 4 (6.5%) patients.
  
  
  CONCLUSIONS
  WE RECORDED SEVERAL NEW TRENDS, LIKE: 1) an increasing age, 2) an increasing proportion of patients with no previously known heart disease, 3) improving culture positivity rates, 4) rise in staphylococcal infections, 5) increased usage of TEE, 6) high elective surgical rate, and 7) apparent improved survival rates. These changes point to the fact that 'modern era' changes in the profile of IE have started to appear in a selected population in India.
authors.affiliation: Depatment of Critical Care Medicine, Fortis Escorts Heart Institute, Okhla Road, New Delhi, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Gupta
authors.forename: Anu
authors.initials: A
authors.lastname: Gupta
authors.forename: Upendra
authors.initials: U
authors.lastname: Kaul
authors.forename: Amit
authors.initials: A
authors.lastname: Varma
keywords: Demographics; echocardiography; infective endocarditis; microbiologic characteristics; rheumatic heart disease